ESPE Abstracts

Background: Primary and secondary prevention of childhood obesity is an essential public health priority.

Objective and hypotheses: To determine relationships between families, genetic and metabolic obesity risk factors in children.

Method: 782 children (204 lean/578 obese; m/f=414/368) aged from 2 to 17.9 years were examined and classified in line with the pubertal stage: 392 prepubertal, 141 early, and 249 late puberty. Family history (FH) of impaired glucose tolerance/diabetes mellitus (IGT/DM), cardiovascular disease (CVD), and obesity (O) was obtained from questionnaires. BMI was calculated and standardized referring to national reference data. 243 obese and 112 lean children were genotyped in INS gene (A-23HphIT polymorphism). In order to assess metabolic changes, serum insulin (INS), cholesterol (Ch), triglycerides (TG), HDL and LDL, glucose levels were detected, and HOMA-IR index was calculated. Statistical analysis was performed using SPSS 16.0 (P=0.05).

Results: INS level was significantly higher in children with FH of CVD (P1=0.001) and O (P2=0.014) than in ones without; vice versa to children with FH of IGT/DM (P>0.05). These patterns of relationships were similar regardless of sex and pubertal stage. In multivariate analysis with INS indexes as dependent variables, parameters independently associated to INS was FH of CVD (β=0.203 P=0.006 in girls and β=0.149 P=0.028 in boys). Family history of IGT/DM and O were not influenced INS levels. There were correlations between LDL and INS (r=0.3, P=0.05) and HOMA-IR index (r=0.3, P=0.05) levels in late pubertal obese children. HDL concentrations correlated with INS (r=−0.5, P=0.003) and HOMA-IR (r=−0.5, P=0.004) in late pubertal overweight girls. INS and HOMA-IR were higher in AA homozygous O children respecting to TT-genotype of INS gene (P=0.003 and 0.006 in order).

Conclusion: FH of CVD and O, AA homozygous genotype of A-23HphIT polymorphism influenced INS level in children. Lipid spectrum in obese children associates with INS and HOMA-IR.